Ask Dr. Mona: Persistence and self-knowledge could help prevent missed, delayed or misdiagnoses

Two team physicians were fired from the New Orleans Saints last week when it was discovered that they had not properly diagnosed defensive back Delvin Breaux’s broken leg. It has been reported that the fracture was diagnosed by another physician who later looked at Breaux’s x-ray.

The team physicians are reported to have said Breaux had a contusion or bruise. A wrong diagnosis is called a misdiagnosis. Because of the misdiagnosis and missed diagnosis, Breaux’s real medical problem wasn’t discovered for weeks, leading to a delay in care.

We don’t know exactly how many missed diagnoses or misdiagnoses there are annually in the U.S. but we know that they are more common than other medical errors. Actor John Ritter died after sustaining an aortic dissection — a tear in the largest blood vessel in the body — while being treated in the hospital as if he were having a heart attack. And actress Natasha Richardson’s death from bleeding in her skull may have been able to be prevented had she agreed to seek immediate care after falling at a ski resort.

Who’s to blame? Some cases are more clear-cut than others. Was the physician rushing? Were some of the medical records unavailable? Small, nondisplaced fractures and small brain bleeds that don’t shift the brain tissue can be difficult to see on any type of x-ray. And many, many signs and symptoms are the same for many medical conditions. One thing is certain: Physicians don’t go to medical school to intentionally provide poor care to patients. Missed diagnoses, misdiagnoses and delays in care can be either accidental or due to multiple breakdowns of individual and system factors.

An initial diagnosis of a contusion or bruise for Delvin Breaux of the New Orleans Saints delayed discovery of the real medical issue, a broken leg.(Photo: Getty Images)

So what can you do, as a patient, if you feel that you have been misdiagnosed or have a missed diagnosis that may lead to a delay in care? Know yourself. If you know something isn’t right, be persistent with your physician. If you feel that you are being put off, seek a second opinion. Timing is essential since, in general, delays in diagnosis can result in longer treatment, more complications or worse outcomes.

Ryan Wood, a physician of podiatric medicine in Palm Springs and La Quinta, who was not involved in Breaux’s care, routinely treats leg injuries. He said, “Usually when we have an injury, we begin with a working diagnosis. With follow-up testing and exams, we can take into account the patient’s response to treatment and further hone in on the problem. Especially in high-level athletes, you must begin with a working diagnosis and then modify it as more information becomes available.”

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Please email comments and your medical questions to AskDrMona@gmail.com. We’ll answer as many as we can in this weekly column. Remember: Your health is your most important asset. Guard it with your life.